Mga Trabaho sa Carelon Global Solutions sa Pilipinas

Auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims. · ...

Position Title: · Customer Care Rep I (PHL)Shift: · Job Description: · Responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues. Must pass the appropriate pre-e ...

Position Title: · USRN Hiring - IloiloShift: · Job Description: · Responsible for collaborating with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources. Ensures medically appropriate, high qu ...

Position Title: · Payroll ManagerShift: · Job Description: · The Payroll Manager shall be responsible for ensuring that the payroll & time keeping functions are operating effectively. · Primary duties may include, but are not limited to: · Managing & ensuring the efficient opera ...

Position Title: · Grievance/Appeals Rep I (PHL)Shift: · Job Description: · Responsible for reviewing, analyzing and triaging correspondence in accordance with policies and procedures. Primary duties may include, but are not limited to: Conducts investigation and review of incomin ...

Position Title: · Performance Quality AuditorShift: · Job Description: · Responsible for evaluating the quality of services and interactions provided by organizations within the enterprise.  · Included are processes related to enrollment and billing and claims processing, as well ...

Responsible for providing marketing support for client events. · ...

Responsible for providing marketing support for Shared Services account and solutions client events. · ...

Position Title: · PHRN - 2024Shift: · Job Description: · Responsible for providing non-clinical support to the Medical Management and/or Operations areas. · Primary duties may include, but are not limited to: · Gathers clinical information regarding case and determines appropriat ...

Position Title: · Nurse Medical Mgmt I (PHL)Shift: · Job Description: · Responsible for collaborating with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources. Ensures medically appropriate, h ...

Responsible for overseeing the security operations command center, electronic security systems, and site emergency management. · Primary duties include but are not limited to: · Managing electronic security systems (ESS) including installation, preventive and corrective maintenan ...

Position Title: · Facilities Project Mgr (PHL)Shift: · 2:00 PM to 11:00PM (Philippines)Job Description: · The Facilities Project Manager leads and manages high-level projects in collaboration with a breadth of vendors, partners, and CGS personnel, with an emphasis on facilities, ...

Position Title: · Multimedia Specialist (PHL)Shift: · Job Description: · Responsible for all in-house design requirements for the organization based on the talent acquisition plan. Liaison with external agencies to ensure the brand guidelines and corporate design are adhered to. ...

Position Title: · DRG Clinical Validation Auditor - IloiloShift: · Job Description: · "Responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG ...

Position Title: · USRN Medical Coder Find Human ResourcesShift: · Job Description: · "Responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) ...

Position Title: · Marketing Operations and Campaign Analyst RoleShift: · 9:00 PM to 6:00AM (Philippines)Job Description: · The Marketing Operations & Campaign Analyst supports the marketing team by ensuring data accuracy and analyzing performance metrics to demonstrate campaign v ...

Position Title: · PHRN TraineeShift: · Job Description: · Responsible for serving in an interim basis as a nurse trainee in the USRN Clinical Academy while obtaining NCLEX certification and USRN license prior to being deployed to a USRN function. · Primary duties may include, but ...

Responsible for the all facilities management of the assigned site. · ...

Position Title: · Clinical Trainer (USRN)Shift: · Job Description: · Primary duties may include, but are not limited to: · Conducts training needs analysis and designs, develops, implements, and evaluates effectiveness of learning solutions · Facilitates knowledge transfer activi ...

++Responsible for translating basic business needs into application software requirements. · +Analyzes business needs to determine optimal means of meeting those needs. · Determines specific business application software requirements to address specific business needs. · Works wi ...